高负压引流治疗乳腺癌术后皮瓣下积液感染的临床效果  

Clinical effect of high negative pressure drainage on treatment of breast cancer patients with postoperative effusion infection under skin flap

作　　者：栾海丽 蔡云辉 卞晓蓉 LUAN Hai-li;CAIYun-hui;BIAN Xiao-rong(Jiangsu Vocational College of Medicine,Yancheng,Jiangsu 224005,China;不详)

机构地区：[1]江苏医药职业学院,江苏盐城224005 [2]盐城市第一人民医院普外科,江苏盐城224002

出　　处：《中华医院感染学杂志》2022年第15期2324-2328,共5页Chinese Journal of Nosocomiology

基　　金：江苏省卫生健康行业科研基金资助项目(190397)。

摘　　要：目的分析高负压引流对乳腺癌术后皮瓣下积液感染患者的疗效及炎症因子水平的影响。方法选择2015年6月-2020年10月在某医院乳腺外科住院治疗的68例乳腺癌术后皮瓣下积液感染患者作为研究对象,采用随机数字表法将患者分为研究组和对照组,每组各34例,两组患者均给予彻底清创及抗感染治疗,对照组患者给予常规负压创面治疗(NPWT),研究组患者采用穿刺置管后连续高负压引流系统及引流瓶进行引流。对两组患者的基线资料、疗效指标及治疗前和治疗7 d时的血清肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6、IL-8、IL-10、降钙素原(PCT)、C-反应蛋白(CRP)水平进行比较。结果研究组患者的换药次数、拔管时间、创面愈合时间、抗菌药物用量分别为(5.68±0.79)次、(7.42±1.76)d、(10.28±2.71)d、(5.52±1.16)g,均低于对照组(P<0.05)。在治疗7 d时,研究组患者的血清TNF-α、IL-6、IL-8、PCT、CRP水平分别为(15.16±4.21)μg/L、(22.08±4.47)μg/L、(0.32±0.11)ng/L、(0.62±0.24)μg/L、(28.18±6.06)mg/L,均较治疗前下降(P<0.05),血清IL-10水平为(15.53±2.17)μg/L,较治疗前上升(P<0.05),上述血清炎症因子水平的变化幅度均高于对照组(P<0.05)。结论与应用常规NPWT相比较,在乳腺癌术后皮瓣下积液感染治疗中应用高负压引流,能够提升治疗效果,降低术后炎症反应水平、促进创面愈合。OBJECTIVE To analyze the therapeutic effects of high negative pressure drainage in treatment of postoperative effusion under skin flap complicated with infection in patients with breast cancer and its influences on inflammatory factors levels to provide evidence for clinical treatments.METHODS Total of 68 patients with postoperative effusion under skin flap complicated with infection after breast cancer surgery in the breast surgery department of a hospital from Jun of 2015 to Oct of 2020 were recruited.The patients were randomly divided into the study group and the control group,34 cases in each group.The patients of the two groups were treated with thorough debridement and anti-infective therapy.The patients of the control group were treated with routine negative pressure wound therapy(NPWT),while the patients of the study group were treated with continuous high negative pressure drainage system and drainage bottle after puncture catheterization.The baseline data,the therapeutic effects indexes and the serum tumor necrosis factor(TNF)-α,interleukin(IL)-6,IL-8,IL-10,procalcitonin(PCT)and C-reactive protein(CRP)levels before and at 7 days after treatment between the patients of the two groups were compared.RESULTS The times of drug changes,extubation time,wound healing time and dosage of antibiotics in the study group were(5.68±0.79)times,(7.42±1.76)d,(10.28±2.71)d and(5.52±1.16)g,respectively,which were significantly lower than those in the control group(P<0.05).At 7 days after treatment,the serum TNF-α,IL-6,IL-8,PCT and CRP levels in the patients of the study group were(15.16±4.21)μg/L,(22.08±4.47)μg/L,(0.32±0.11)ng/L,(0.62±0.24)μg/L and(28.18±6.06)mg/L,respectively,which were significantly lower than those before the treatment(P<0.05).The serum IL-10 level was(15.53±2.17)μg/L,which was significantly higher than that before the treatment(P<0.05).And the changes of the above-mentioned serum inflammatory factors were significantly higher than those in the control group(P<0.05).CONCLUSION Compared

关 键 词：高负压引流 乳腺癌 术后皮瓣下积液 感染 疗效 炎症因子 

分 类 号：R619[医药卫生—外科学]